Early signs of stroke misdiagnosed in almost 13% of stroke victims

Almost 13% of stroke victims not receive treatment for the condition, researchers report. According to the study published online in the journal Diagnosis, this may be because many emergency department doctors do not correctly identify the signs of stroke.
David Newman-Toker, MD, of Johns Hopkins University in Baltimore, and colleagues analysed data from more than 187 000 people who visited more than 1000 US hospitals in nine states during 2008-09.

Many of those misdiagnosed had headache or dizziness, and those were considered probable missed strokes, the study found.

Several types of patients had an increased likelihood of experiencing a missed stroke for example, the risk of misdiagnosis was 33% higher in women and 20% to 30% higher in minorities. Also younger people were nearly seven times more likely to be misdiagnosed.

“This study provides some immediate suggestions to ED physicians who are evaluating patients with these symptoms — be more attuned to the possibility of stroke in younger, female, and non-white patients,” researchers wrote.

“Though ‘simple’, indiscriminate use of neuroimaging will not prove an effective strategy to detect stroke in these patients,” they added. “Instead, clinicians should leverage well-studied bedside methods to identify dizziness and headache patients at high risk for stroke.”

Based on their findings, the researchers estimated that the number of missed strokes nationwide each year could be between 15 000 and 165 000.

Early recognition of stroke symptoms is crucial because there is a small window of time–three hours–after symptoms start in which many patients can be treated with clot dissolving drugs. Such drugs can substantially increase the risk of survival without long-term complications.